Peritonitis

Peritoneum is a lining of tissue that covers most of the internal organs as well as the inner side of the abdominal wall. Peritoneal fluid is present in the space between the lining layers (peritoneal space). Inflammation of the peritoneum is called peritonitis, a serious condition that requires prompt treatment to avoid complications.

Peritonitis usually occurs when the peritoneum is infected due to rupture. This can happen with an abdominal injury or surgery or when a dialysis catheter or feeding tube is used. It can also occur due to a stomach ulcer, ruptured appendix, perforated colon, diverticulitis (inflammation of intestinal pouches) and pancreatitis. Spontaneous peritonitis occurs when the peritoneal fluid is infected and builds up without rupture of the peritoneum such as in liver cirrhosis or with liver or kidney failure.

With peritonitis, you may experience abdominal pain, bloating, fever, nausea, vomiting, loss of appetite, fatigue, increased thirst and decreased urine output, diarrhea or inability to pass stool. If you are receiving dialysis, your dialysis fluid may be cloudy or clumpy in appearance. Left untreated, the infection may enter your bloodstream and spread to the rest of your body causing sepsis, a life-threatening condition resulting in circulatory shock and organ failure.

When you present to the clinic with peritonitis, your doctor will review your symptoms and medical history and perform a physical examination along with certain tests. Blood tests help determine the presence of infection. Imaging studies such as an X-ray or CT scan are performed to view areas of rupture or other abnormalities. A sample of peritoneal fluid may be drawn for laboratory analysis with the help of a thin needle.

Treatment depends on the severity of peritonitis but usually requires a hospital admission. Antibiotics are administered to control infection. Surgery may need to be performed to remove infected tissue such as that of the colon or ruptured appendix. Pain control medications as well as intravenous fluids and a blood transfusion may be necessary. If you are receiving peritoneal dialysis, it may be discontinued and an alternate route of administration adopted at least until the infection clears. Good hygiene of the peritoneal dialysis catheter site helps prevent peritonitis.